Portolani Nazario, Baiocchi Gian Luca, Coniglio Arianna, Piardi Tullio, Grazioli Luigi, Benetti Anna, Ferrari Bravo Andrea, Giulini Stefano Maria
Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, P.le Spedali Civili, 1, 25123, Brescia, Italy.
Ann Surg Oncol. 2008 Jul;15(7):1880-90. doi: 10.1245/s10434-008-9933-y. Epub 2008 Apr 29.
Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.
The clinicopathological data of 67 patients with ICC and combined hepatocellular-cholangiocarcinoma (HCC-ICC) are presented.
HCV-HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.
Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC-ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.
肝内胆管癌（ICC）是一种罕见的肿瘤。
介绍了67例肝内胆管癌及肝细胞-胆管癌合并症（HCC-ICC）患者的临床病理资料。
37.3%的病例存在HCV-HBV感染，38.7%的病例存在慢性肝病，这一比例高于正常人群；在这些患者中，癌症较小，通常无症状且为合并型。51例患者接受了肝切除术；1年、3年和5年的总生存率分别为87.9%、59.0%，无病生存率分别为47.7%、78.8%、51.4%和46.7%。通过肝癌筛查程序诊断出ICC的肝硬化患者组结果较好（5年生存率76.6%）。淋巴结转移对总生存和无病生存均显示出负面预后价值；在N+患者中，肝切除和淋巴结清扫术后的平均生存时间为14.7个月。
病毒感染和肝硬化可能被视为肝内胆管癌及肝细胞-胆管癌合并症的危险因素；接受手术切除的患者生存率良好。淋巴结转移不应被视为肝切除的禁忌证。
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